Female Infertility
Causes, Diagnosis & Treatment
Female factor infertility accounts for approximately 40% of all infertility cases. With early diagnosis and advanced reproductive technologies, the vast majority of female fertility issues can be treated successfully.
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1 in 6
Couples face infertility
25%
Caused by ovulation disorders
Super High
Success Rates
35+
Age when fertility declines faster
Common Female Fertility Conditions
Click on a condition to learn more about causes, symptoms, and treatment
PCOS — Polycystic Ovary Syndrome
PCOS is a common hormonal condition that causes irregular ovulation. Lifestyle changes, ovulation tablets, IUI or IVF can help many women conceive.
Endometriosis
Endometriosis is tissue similar to the womb lining growing outside the uterus. It can cause pelvic pain and reduce fertility, but treatment can help.
Uterine Fibroids
Fibroids are non-cancerous growths in the uterus. Depending on size and position, some affect fertility and may need treatment before pregnancy.
Blocked Fallopian Tubes
Blocked fallopian tubes stop the egg and sperm from meeting. Tests like HSG find the problem, and surgery or IVF can help you conceive.
Poor Ovarian Reserve (Low AMH)
Low AMH means fewer eggs remain in the ovaries. It does not rule out pregnancy, but it often means treatment should not be delayed.
Premature Ovarian Failure
Premature ovarian failure, or POI, is loss of normal ovarian function before 40. Hormone therapy protects health, and donor egg IVF offers a path to pregnancy.
Hypothyroidism & Fertility
An underactive thyroid can disturb ovulation and raise miscarriage risk. A simple TSH test finds it, and daily thyroxine usually corrects it.
Hyperprolactinemia
Hyperprolactinemia means high prolactin levels, which can stop ovulation. Once the cause is found, medicines such as cabergoline usually restore it.
Uterine Polyps
Uterine polyps are soft growths in the uterine cavity that can prevent embryo implantation and are easily removed hysteroscopically.
Thin Endometrium
A thin endometrium is a womb lining that does not grow thick enough for an embryo to implant. Finding the cause helps guide treatment.
Cervical Factor Infertility
Cervical factor infertility occurs when the cervical mucus prevents sperm from reaching the egg, often addressed successfully with IUI or IVF.
Recurrent Implantation Failure
Recurrent implantation failure is when good-quality embryos repeatedly fail to implant after IVF. Careful testing can guide the next steps.
Asherman Syndrome
Intrauterine adhesions formed after uterine surgery or infection obliterate the cavity, blocking implantation and causing recurrent pregnancy loss.
Uterine Septum
A midline fibrous partition within the uterine cavity is the most common Müllerian anomaly and consistently associated with increased miscarriage rate.
Bicornuate Uterus
Partial fusion failure of Müllerian ducts creates a heart-shaped uterus, increasing miscarriage and preterm birth rates.
Unicornuate Uterus
A Müllerian anomaly where only half the uterus forms, significantly increasing risks of miscarriage, preterm birth, and malpresentation.
Arcuate Uterus
A mild uterine anomaly with a small midline indentation of the uterine fundus. Associated with second-trimester loss; impact on first-trimester loss is debated.
Cervical Stenosis
Narrowing of the cervical canal impedes sperm entry and embryo transfer procedures, and can cause retrograde menstruation contributing to endometriosis.
Proximal Tubal Obstruction
Blockage at the cornual end of the fallopian tube prevents sperm from reaching the egg. Often due to tubal spasm, polyps, or salpingitis isthmica nodosa.
Distal Tubal Obstruction
Blockage at the fimbrial end of the tube prevents egg pick-up. Often results from adhesions secondary to endometriosis or pelvic infection.
Peritubal Adhesions
Fibrous bands around the fallopian tubes impair their mobility even when the tubal lumen is patent, reducing natural conception rates.
Endometrial Hyperplasia
Overgrowth of the uterine lining due to unopposed oestrogen. Atypical hyperplasia carries malignant risk and must be treated before IVF.
Chronic Endometritis
Persistent low-grade inflammation of the endometrial lining caused by bacteria, impairing embryo implantation. Often asymptomatic and missed on routine investigation.
Ovarian Hyperstimulation Syndrome (OHSS)
An IVF complication where excessive follicle recruitment causes fluid shift, ovarian enlargement, and in severe cases cardiovascular compromise.
Ovarian Torsion
Twisting of the ovary on its ligamentous supports cuts off blood supply and can cause irreversible ovarian damage if not surgically corrected promptly.
Ovarian Cysts — Functional
Follicular or corpus luteum cysts form during normal ovarian activity. Most resolve spontaneously but can delay IVF stimulation.
Poor Ovarian Response
Fewer than 3 oocytes retrieved in a stimulated IVF cycle despite maximal stimulation. Classified by the Bologna criteria.
Premature Ovarian Reserve Decline
Low AMH and AFC in women under 35, years before expected menopause. Requires urgent fertility evaluation and possible egg banking.
Antiphospholipid Syndrome (APS)
An autoimmune prothrombotic condition that causes placental microthrombi, leading to recurrent miscarriage (especially second-trimester) and thrombosis.
Natural Killer Cell Elevation
Elevated uterine or peripheral NK cells are associated with recurrent miscarriage and implantation failure. Immunological protocols may help.
Systemic Lupus Erythematosus and Fertility
SLE can reduce ovarian reserve, cause recurrent pregnancy loss, and increase preterm birth risk. Requires multidisciplinary management.
Turner Syndrome (45,X)
Absence of one X chromosome causes premature ovarian insufficiency. Spontaneous pregnancy is rare; egg donation is the principal fertility option.
Fragile X Premutation (Female Carriers)
Women with 55–200 CGG repeats in FMR1 have a 20% risk of premature ovarian insufficiency and a 50% chance of passing the full mutation to sons.
Thrombophilia and Recurrent Miscarriage
Inherited or acquired clotting disorders cause placental microthrombi, resulting in miscarriage or foetal growth restriction.
Ectopic Pregnancy
Implantation outside the uterine cavity is life-threatening and may result in tube removal, reducing future natural fertility.
Recurrent Miscarriage — Second Trimester
Two or more pregnancy losses between 12–24 weeks. More likely to have structural or thrombotic causes than first-trimester losses.
Hydrosalpinx and IVF Failure
Fluid from a hydrosalpinx drains into the uterine cavity and is embryotoxic, reducing implantation rates by up to 50%.
Prolactinoma
A benign pituitary adenoma that hypersecrets prolactin, suppressing GnRH and causing amenorrhoea, galactorrhoea, and infertility.
Recurrent Miscarriage — First Trimester
Two or more pregnancy losses before 12 weeks. A structured investigation finds a treatable cause in ~50% of cases.
Pelvic Inflammatory Disease (PID)
Ascending genital tract infection damaging the fallopian tubes, leading to tubal factor infertility in up to 20% of affected women.
Genital Tuberculosis
Mycobacterium tuberculosis infection of the female genital tract causes severe tubal occlusion and endometrial scarring — a significant cause of infertility in India.
Vaginismus
Involuntary spasm of vaginal muscles prevents penetration, making natural intercourse impossible. Requires medical and psychological management.
Social Egg Freezing
Elective oocyte cryopreservation allows women to preserve fertility before age-related decline, providing flexibility for later parenthood.
Luteinised Unruptured Follicle Syndrome
The dominant follicle undergoes luteinisation but does not rupture to release the egg despite normal LH surge and progesterone rise.
Endometriosis — Deep Infiltrating
Endometriosis implants penetrating >5 mm into peritoneal tissue affect the uterosacral ligaments, rectovaginal septum, bowel, or bladder, causing severe pain and reduced fertility.
Infrequent Periods (Oligomenorrhoea)
Cycles longer than 35 days indicate infrequent ovulation, common in PCOS and hypothalamic amenorrhoea. Significantly reduces monthly chances of conception.
Endometriosis — Superficial Peritoneal
Stage I–II endometriosis with peritoneal implants. Altered peritoneal environment and inflammatory cytokines may impair fertilisation.
Adenomyosis
Adenomyosis is when womb-lining tissue grows into the muscle wall of the uterus, causing painful, heavy periods. It can affect fertility and IVF.
Endometrial Receptivity Problems (Implantation Window)
A displaced window of implantation where the endometrium reaches peak receptivity earlier or later than assumed. Detected by the ERA test.
Donor Egg IVF
IVF using eggs from a young donor offers the highest success rates (~50–60% per transfer) for women with poor reserve or premature ovarian failure.
Premature Menopause Risk Assessment
Women with family history of early menopause, FMR1 premutation, or autoimmune conditions should have proactive ovarian reserve testing and fertility counselling.
Empty Sella Syndrome
The sella turcica appears empty on MRI due to CSF herniation. May be associated with hypopituitarism causing FSH/LH deficiency and infertility.
Luteal Phase Defect
Insufficient progesterone production after ovulation shortens the luteal phase, preventing adequate endometrial preparation for embryo implantation.
Congenital Adrenal Hyperplasia (Non-classic)
A mild late-onset form of CAH caused by 21-hydroxylase deficiency, resulting in androgen excess that can mimic PCOS and impair ovulation.
PCOS with Insulin Resistance
A common PCOS subtype where cells do not respond effectively to insulin, leading to elevated androgen levels that disrupt ovulation.
PCOS with Lean Phenotype
PCOS occurring in women of normal body weight. Often underdiagnosed because the classic overweight presentation is absent, yet anovulation still impairs fertility.
Hyperandrogenism
Excess androgen (male hormone) levels in women, disrupting ovulation and causing hirsutism, acne, and menstrual irregularity.
Hypothalamic Amenorrhoea
Loss of menstruation due to suppressed GnRH secretion, often triggered by extreme energy deficit, excessive exercise, or psychological stress.
Cushing Syndrome
Prolonged exposure to high cortisol levels disrupts the HPG axis, suppressing ovulation and causing metabolic and reproductive dysfunction.
Hyperthyroidism and Infertility
Excess thyroid hormone disrupts the menstrual cycle and increases miscarriage risk. Graves disease is the most common cause in women of reproductive age.
Thyroid Antibodies and Fertility
Elevated anti-TPO antibodies — even with normal TSH — are associated with implantation failure, recurrent miscarriage and reduced IVF success.
Uterine Fibroids — Submucosal
Fibroids growing into the uterine cavity distort the endometrial lining, reducing implantation rates and increasing miscarriage risk.
Uterine Fibroids — Intramural
Fibroids embedded within the myometrium; those >4 cm or distorting the cavity can reduce IVF implantation rates and increase preterm labour risk.
Common Causes of Female Infertility
Understanding the root cause helps our specialists create a targeted treatment plan
Ovulation Disorders
PCOS, hormonal imbalances, and thyroid disorders can prevent regular ovulation, the most common cause of female infertility.
Tubal Damage or Blockage
Blocked or damaged fallopian tubes prevent the egg from meeting sperm, often caused by infections or endometriosis.
Endometriosis
Tissue similar to the uterine lining grows outside the uterus, causing inflammation, scarring, and reduced fertility.
Diminished Ovarian Reserve
Low egg count or poor egg quality, indicated by low AMH levels, which naturally declines with age.
Uterine Abnormalities
Fibroids, polyps, or structural issues in the uterus can interfere with implantation or pregnancy maintenance.
Age-Related Decline
Female fertility naturally declines after 35, with a significant drop after 40 due to reduced egg quality and quantity.
Diagnostic Tests
Our comprehensive female fertility evaluation includes
AMH Test (Anti-Mullerian Hormone)
Blood test that measures ovarian reserve — the quantity of eggs remaining. A key indicator of fertility potential.
Hormonal Panel
Blood tests for FSH, LH, estradiol, progesterone, prolactin, and thyroid hormones to assess the hormonal environment.
Transvaginal Ultrasound
Imaging of the uterus and ovaries to check for fibroids, polyps, cysts, and to perform antral follicle count (AFC).
HSG (Hysterosalpingography)
X-ray with contrast dye to evaluate whether the fallopian tubes are open and the uterine cavity is normal.
Hysteroscopy
Direct visualisation of the uterine cavity using a thin camera to diagnose and treat polyps, fibroids, or adhesions.
Laparoscopy
Minimally invasive surgery to diagnose endometriosis, tubal damage, ovarian cysts, and other pelvic abnormalities.
Age & Female Fertility
A woman's fertility is closely linked to her age. Understanding this relationship helps in making informed decisions about family planning.
*Per-cycle conception rates are approximate and vary by individual
Treatment Options
Personalised treatment plans based on your specific diagnosis and age
Ovulation Induction
Medications like Clomiphene or Letrozole to stimulate regular ovulation in women with ovulatory disorders.
IUI (Intrauterine Insemination)
Processed sperm is placed directly in the uterus during ovulation, ideal for mild infertility or unexplained cases.
IVF (In Vitro Fertilisation)
Eggs are retrieved, fertilised in the lab, and embryos are transferred to the uterus. Gold standard for many causes.
Egg Freezing
Preserve your fertility by freezing eggs at their current quality for future use, especially recommended before 35.
Laparoscopic Surgery
Minimally invasive treatment for endometriosis, fibroids, tubal blockages, and ovarian cysts.
Donor Egg IVF
Using donated eggs for IVF when ovarian reserve is severely depleted or egg quality is compromised.
When Should You See a Specialist?
Consider consulting a fertility specialist if:
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